Race May Be Factor in Lower Head and Neck Cancer Survival in Blacks

Survival rates for head and neck cancers have dramatically improved over the last 37 years, with the exception of African-Americans, leading researchers at the University of Missouri School of Medicine to conclude that race may be a factor. Lead investigator for the study Shahzad Raza, MD, said that although all other ethnic groups included in the study showed improved five-year survival rates over a 40-year period, the five-year survival rates for African-Americans were significantly decreased.

Raza said that a common theory in cancer survival has been that socioeconomic status, the patient’s access to health care, and the stage at which the cancer was diagnosed played significant roles in African-American cancer survival rates. Since the study, the researchers say these factors are not necessarily accurate predictors, and suggest that it is possible that genetic factors in the African-American race may cause a resistance to treatment in some tumors, such as head and neck cancers.

Over 52,000 people in the U.S. have head and neck cancer. This includes cancers of the pharynx, larynx, salivary glands, oral cavity, and nose or nasal passages. According to the National Cancer Institute, these cancers account for about 3 percent of all malignancies in the U.S. Alcohol and tobacco use are the most important risk factors in most head and neck cancers. Oropharyngeal cancer, another type of head and neck cancer, can be caused by human papillomavirus (HPV) infections.

There are no routine screening tests for head and neck cancers. Standard treatments include chemotherapy, radiation therapy, and surgery, depending on which type of cancer exists. Raza said treatment depends on the location of the tumor, the stage of the cancer, and the age and overall health of the patient. The National Cancer Institute estimates that about $3.6 billion is spent in the U.S. each year treating head and neck cancers.

The study analyzed data collected on 247,310 head and neck cancer patients throughout the nation over a period spanning 1973 to 2010. The study sample was made up of five ethnic groups. Researchers found that the incidence of head and neck cancer was higher in African-Americans than Caucasians, Asians and Pacific Islanders, Hispanics, Alaska Natives, or Asian-Indians. The study also showed that all of the ethnic groups showed improved five-year head and neck cancer survival rate over the 37-year period except for African-Americans, leading researchers to conclude that race may indeed be a factor.

Researchers found that the prognosis for African-Americans with head and neck cancers has not improved, despite advances in treatment options, with five-year survival rates of only 41.8 percent. This compares with 60.8 percent for Caucasians, 59.3 percent for Hispanics, 62 percent for Asians and Pacific Islanders, and 50.2 percent for Asian-Indian and Alaska Natives.

Researchers suggest that perhaps inherent genetic factors in the African-American race may make tumors more resistant to treatment. They say that the study results show an “urgent need” for a national trial within the African-American community on head and neck cancers, to study biogenetic markers and new forms of treatment to try and determine factors causing decreased survival rates in this particular race.